Shocking Medicine Prices!

Updated on November 29, 2011
J.B. asks from Katy, TX
26 answers

I was very recently prescribed a medicine for the form of arthritis I have. I took the script to the pharmacy who then told me my insurance needed a referral from the Dr. (I thought since the script came from a Dr..??) Anyway, the Dr. sent the 'referral' to the insurance company and I'm waiting to hear back.
The Dr. told me this is normal and no worries...... But I asked why and she said the medicine is $1900.00 A MONTH! Holy sh*t! My mom takes this same med for the same thing and she said when she was prescribed it 4 years ago it was about $5000.00 a month. Some of you may be saying DUH, but I don't consider myself a sickly person, maybe been to the Dr. 3 times in the last 10yrs, so that's the reason for my shock.
So, anyone else have a ridiculously priced med? I had no idea

What can I do next?

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So What Happened?

I will only be responsible for the co-pay obviously. It is a drug all of you have seen commercials for, the golfer Phil Mickelson is on the ad. It is an self injection, created for Psoriatic arthritis.

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P.B.

answers from Houston on

I'm like you - haven't been to dr. in forever. My hands and bottoms of my feet are soooooo itchy, so went to dermotologist. He prescribed a cream for me. Gave me a coupon for "the rest of the deductible/co-pay" (up to $200) and my portion was still $236 for 6 oz of cream!!!!!!!!!!!!!!!!!!! Needless to say, I found Gold Bond somewhere and it works just fine for $4 a tube!!!!!

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L._.

answers from San Diego on

No, and I'd live with the pain before I'd pay that kind of money. I really think it's rediculous. I've had a LOT of very SEVERE pain in my life. But there's just no way. I can't even imagine the co-payments we would have to pay for a medicine that expensive. I'm so glad that I finally found out that I don't have to be in pain at all. :) My Lord has taken care of it all.

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A.C.

answers from Madison on

This is why it's important for people to turn to naturopathic medicine/alternative medicine/integration medicine and fix the problems in their body so that they don't need to rely on pharmaceutical drugs.

Yes--it can be done. Sometimes it takes awhile to get everything that's messed up inside the body regulated and working correctly again, but it IS possible. It took my 4 years, but I am off all 12 of the pharma drugs I was on. You do have to agree to change the type of foods you eat (organic, grass-fed, do away with fast food, processed, anything with excitotoxins) and your lifestyle and not eat any food your body might be allergic/intolerant to, but it is worth it.

It is said that every ill or pain or problem the human body has, alternative medicine can fix it. Cancer can be cured--if you truly want to be cured.

I would have never believed it, either, until I got horribly sick and discovered that the allopathic doctors weren't interested in helping me figure out/discover the root cause of my problems, but the alternative doctors/alternative medical community was. Now I am pharma free (and we're talking drugs for severe acne, severe high blood pressure, asthma and allergies, what they called depression or Seasonal Affective Disorder (and was really a deficiency in Vit D--very easy and cheap to fix; just take Vit D3)--all meds that cost in the hundreds of dollars.

If you think that's a ridiculous price for your meds, just wait--I can guarantee you that the price will keep going up and up and up. That's how the pharmaceutical companies stay in business--by making sure you're sick, by making sure you "need" the drug to control your "problem." They want you sick and on drugs, because then they can make you pay for those drugs and they can charge you any amount they want--because you need the drug.

Make a pact with yourself right now that you don't want to be a part of the pharma clog and that you'll find a way to get off the drugs. You'll feel better, your pocketbook will be heavier, and your lifespan will increase.

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R.J.

answers from Seattle on

All I have to say is "no insurance for 6 years".

Okay, not all.

Can we say $750 for labs? $500 for a single immunization? A single "well child" checkup usually cost us about $1500 dollars. And SICK? Add 3 more sets of labs, and 475 for antibiotics? Then there was the migraines...$125 a pill for migraine meds? $10,000 starting price on a trip to the ER?

My son's meds this summer (just the meds) came to a tune of a little over $45,000. ((The total bill, out of pocket would have been several million, and I'm not including things like CT contrast or anesthesia)). Fortunately we HAVE insurance at this point. But our copays from Feb-June came to a grand total of 8k. I have friends, though, whose children are on Million Per Week care. And a LOT insurance does NOT cover. Like a $70,000 bed just to get the list started.

We currently pay about $400 a month in copays on his Rx's.

I've worked in healthcare for years, and come from a medical family. My grandfather has his own pharmacy. He wasn't a pharmacist, he was a doctor. He kept himself stocked, because (well, first off he did housecalls, and brought what was needed), when you're sick and can't pay, you still need the medicine. He'd just take payments over time, and charged them what he was.

You know how the homeless population more than doubled in a year about 10 years ago? Know why? Bush cut funding for psychiatric meds. Now... pharma WILL give someone free meds for a year, but only for a year. Psych meds often run 5k-10k per month with no insurance. Formerly high functioning contributing members of society, with no meds, lose their jobs and end up on the street. That simple. Direct proven correlation with that particular population upsurge. With over 40 million people without insurance just recently... I'd expect the numbers did another big jump... but I haven't looked at the numbers.

I DO KNOW that thousands and thousands of people are dying every year from treatable illnesses, that emergency care has SKYROCKETED (because people can't afford to see a GP so they wait and "hope", until it gets so bad that there is an immediate threat to life), and don't even get me started on cancer patients. Know a HUGE booming job area in medicine? Social workers who specialize in death and dying. Because cancer isn't being caught early. People are coming in with n-stage cancer (and even worse) when people who have cancer that is caught early... they DON'T HAVE THE MONEY to pay for treatment. ((Yes, there are a lot of orgs that can help. Like putting a finger in a crack in the dam... or paying $20 on a mortgage of $2000... there just ISN'T ENOUGH MONEY for the people who need it)).

I could go on. And on. This is soooooo just the tip of the iceberg. It's disgusting. Literally disgusting.

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R.R.

answers from Dallas on

My daughter that had a transplant has to take meds daily for the rest of her life. To pay out of pocket is well in excess of 5K to 8K per MONTH. No getting around taking them, no generics (extremely delicate balance in the blood stream - when they get it right, they MUST stay with it). And there is no natural alternative - she had a very un-natural procedure - so medical science literally keeps her alive. She was on her hubby's insurance, but recently was approved for disability - and receives medical care through that. So for years, even the copays for her meds ran between $300 and $500 per month. For a short time, she was on a daily shot that cost $1000 per SHOT, twice per day for about 2 weeks. No wonder our medical system is in such shambles!

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A.S.

answers from Boca Raton on

Before it's all said and done the pharma industry will make the military industrial complex look like a bunch of amateurs.

JMO.

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P.M.

answers from Portland on

I've got some pretty expensive meds, and several more added lately that I've had to ask for older, less-expensive versions of because my $6000 yearly deductible on my insurance policy leaves me paying out-of-pocket for virtually every scrap of medical care I get, on a small salary, with nearly half my income going for a monthly insurance premium.

Subsequently, I'm doing without several "urgent" tests and biopsies for a serious rheumatic illness, and an inexpensive steroid which would require impossibly-expensive medical monitoring and the addition of a couple of costly drugs to help manage the side effects. Because this is simply out of my reach financially, I'm crossing my fingers, and risking damage that could cause major arterial damage or cost me my vision – and I'm an artist/illustrator. And I live with pretty severe pain every day.

We live in scary times (probably less so than the people in many developing nations). But if we had a single-payer system, the insurer would have the power to negotiate significant limits on our current health-if-you-can-afford it system.

I know many people who are afraid of what changes that might bring to a system that's still working for them now. But a for-profit health industry is bad for all of us, ultimately, and prices are truly out of control. More folks fall off the shrinking life-boat daily. And for people like me, health care is already rationed, based entirely on cost.

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E.M.

answers from Honolulu on

Um, my husband used to make medication (he made injectables like insulin and the flu shots) and do you have any idea the amount of time it M. take to get the drugs right? It can take days to make a batch of pills. That means paying some person with a degree in chemistry the going rate (98,000 a year) to just make one batch of pills that week. Then add in the cost of the supplies? Who are we kidding?

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M.C.

answers from Washington DC on

My Aunt has a monthly medicine that is $1200 a month that insurance has decided that they are going to stop paying.

My FIL has diabetes. His home delivery of insulin is being stopped because Medicare won't pay them the $1000 a month that they want. So he'll 'need to find a new supplier'....

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A.F.

answers from Fargo on

My husband and both of my kids all have Type 1 diabetes. The cost of supplies and insulin would make your head spin.
I hear alot about "Big Pharma" and how we are too dependent on drugs, and to an extent, I agree. HOWEVER........ Type 1 diabetes cannot be "cured", even though one of your poster claimed that, "It is said that every ill or pain or problem the human body has, alternative medicine can fix it."

I used to be as alternative as it gets, as far as health and medicine, but the reality is that sometimes we need doctors and conventional meds! I am very thankful for the availability of insulin and all the supplies we need as I am sure you are thankful that you can get the shot you need for arthiritis. Now, if they would just start including a little package of smelling salts to be ready when we see the price.......we'd be set! :)

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C.P.

answers from Columbia on

I had an accidental goof-up when I got my new orders (military) and lost coverage for three days. I didn't even know about the lapse (which has since been fixed) until I went to the pharmacy to fill my son's prescription. The cost for uninsured is $560!!! For 30 friggen pills!!!

I know that it costs a lot to research and trial a new drug, but REALLY? I can't wait for it come out in a generic!

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L.K.

answers from Kansas City on

I admit I didn't read all the responses, but Riley has several good points.

I haven't worked clinically in several years, I'm a nurse, but when I worked in lung specialists office 15-16 years ago, we often had patients coming in asking for samples or help getting the meds. I've seen similar questions and posts and even commercials from the drug companies themselves saying 'let us know how we can help you." Unless things have changed, they make the process very difficult and time consuming probably on purpose! There were multiple forms to fill out and they wanted very detailed financial information to make sure the patient truly qualified for their 'help'. I remember one patient getting denied because she had a credit card and it was seen as an 'asset' and therefore since she had assets did NOT qualify for free or discounted meds. That credit card was maxed out because she used it to pay for her medications. It had come down, as it does for many (and remember this was many years ago) did she pay for her meds or food.

I won't get into the politics, but those few years in the office and then my few years doing contract research work within the pharmaceutical made me see the whole industry in a completely different light.

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C.O.

answers from Minneapolis on

Wow! And I thought my son's inhaler at $50 was bad.

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E.M.

answers from St. Joseph on

I used to work as a Pharmacy Tech about 12 years ago. I hated when the senior citizens would come in for their monthly meds and i'd have to look them in the eye and tell them their total was $1200 and then they would be EXCITED because it was $50 less than the previous month. Or the person who needed their anti-rejection meds to keep their transplanted kidney alive but couldnt afford the $900 a month. It can be so ridiculous. when I was pregnant with the twins I had to take Lovenox shots once a day (it is a blood thinner and I had to take it due to my prior medical history). At first I was hysterical because without insurance it was about $1300 a month and when I called the insurance they had said they werent sure it would be covered. It was the only med I could safely take. Thank God they ended up approving it and I had to only pay $30 a month. It can be so sad, scary and frustrating.

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R.S.

answers from San Antonio on

I had a migraine medication that cost $150 per pill...and sometimes it took two pills to get rid of the migraine.

It has finally gone generic and I can get 24 for them for $10.00.

Had a pain management doctor prescribe me a drug that would have cost me $220 a month to take...that was my payment after insurance...not sure what it would be without insurance. But I told him I couldn't take it...because I couldn't afford the co-pay.

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C.W.

answers from Santa Barbara on

Is this a compounding pharmacy where the pharmacists have to "cook" the medication themselves? I would think with arthritis there would be a million of other options before this. I would call back and ask what else you can take. This is something that should have been discussed with you there (the doc knows it's expensive).

Mine is so low compared to yours...$240/month with insurance to pay the rest.

***Added - Thank you Christy for even realizing that it takes $$ actually billions and billions of dollars to bring a drug to market so it only seems fair that they have the rights to it for a while to make some of it back after all the research and development that went into it. It is such a small percentage of medications/compounds that actually make it to market so all those billions and billions are gone.

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J.B.

answers from Boston on

Nuts, but not surprising. When I was a gestational carrier the drugs that I took to support the IVF cycle and embryo transfer were not covered by insurance. I don't know how much the babies' parents paid, but they did pay for these in cash. I believe that one of the medications that I took was over $1000 for a month's supply and I had to take it for 12 weeks.

At my job, our pharmaceutical clients have the highest performing employer stock, the most generous benefits, and the highest paid employees. Great industry to work in, awful industry to have to do business with. A list of the top 25 highest paid CEOs in my state includes two pharmaceutical companies whose CEOs made $9.4M and $14.9M in 2010. But all the money they charge for prescriptions (and take in grants from the government and private fund raising) goes towards R&D and searches for cures...right...

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M.B.

answers from Orlando on

My sons medicine would cost about about 500$ per month for one script and another would be about 700$ and that's just 4 patches. Thank goodness we have insurance!

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M.C.

answers from Dallas on

Ask your rheumatologist about drug company discount plans. I have PA too, and I'm on a competing biologic drug. The drug company covers my copay down to $5 per month.

No, there's no generic for any of the biologic medications, but there are competitors, which makes things a little better and cheaper!

I'd love to fix it with lifestyle and diet, and I've tried a wide range of natural remedies in the past 30 years, but sometimes the drugs really are what works.

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☆.A.

answers from Pittsburgh on

Well, that's the drug companies working for you!

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J.L.

answers from Chicago on

Yep...I found out too why meds sometimes are so expensive. What happens is a pharmaceutical company comes up with the new kind of medicine and then they get approved. They get sole rights to create and sell it until the patent runs out which sometimes is like 10 years. That means they have no competition so they can charge whatever the heck they want...I am so sorry I can't think of the article off hand but I was blown away.

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D.B.

answers from Charlotte on

J., tell the doctor you need the closest equivalent or generic. I can't imagine what your co-pay is. And I really hope there IS a close equivalent for you. Wow.

There is a stomach med called Nexium that docs prescribe a lot. A shocking number of people who work in my husband's company take it, and it is very expensive. The company pointed out to everyone how much would be saved by telling the doc to prescribe a generic equivalent. I'm so glad my husband doesn't have to take this medicine (well, yet!).

I hope that you can get some help on this!

Dawn

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L.S.

answers from San Francisco on

This is happening all over the place. My new insurance will not cover my migraine medicine. They put me on a different drug that has a generic option, but it does not work. The medicine I need is $30 per pill. If I am having a bad month, this could easily cost me $300 bucks in spite of the fact that I have double insurance (my employer requires that I have coverage through my husband and also through myself as we work for the same place). This is the scary thing....to cut costs, many companies are switching to higher deductible insurance that places more limits on patients. More and more people with insurance are finding it harder to pay their bills.

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D.N.

answers from Chicago on

My husband takes a non-formulary med that requires a referral also. The med costs less than $300 a month and we only pay the co-pay but still need that approval. My son takes a medication that costs, for now anyway, about $12,000 a month and it will only go up as he grows. It is based on his weight and the volume will increase as he does. I will NOT complain about insurance since they do cover it even though some of the coverage sucks. I just wish I had a better way to cover deductibles and co-pays.

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D.B.

answers from Madison on

When I was pregnant with my 6 year old, I was sick - way beyond morning sickness actually. I tried about 3 or 4 different meds and none worked, finally they prescribed zofran - it was so expensive I only could get 4 days worth at a time - $100 every 4 days!!! Talk about expensive!! We hit out out of pocket for meds in November then it started over in January - ughh!! I think there's a generic now - thank God I wasn't as sick with my last one!!

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L.F.

answers from San Francisco on

I completely understand. I take a few medicines currently and one of them is 1000 a month!!!! Its ridiculous!!!!! I pay a smaller portion of it, but its still outrageous!

M

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